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Public Health Law in a New Century. Part III: Public Health Regulation: A Systematic Evaluation

Author

Gostin, Lawrence O.

Bibliographic Citation

JAMA. 2000 Jun 21; 283(23): 3118-3122.

Abstract

Public health interventions need justification because they intrude
on individual rights and incur economic costs. Coercive interventions can be
justified in only 3 cases: to avert a risk of serious harm to other persons,
to protect the welfare of incompetent persons, and, most controversially, to
prevent a risk to the person himself/herself. This article proposes a
systematic evaluation of public health regulation. The article recommends that
public health authorities should bear the burden of justification and,
therefore, should demonstrate (1) a significant risk based on scientific
evidence; (2) the intervention's effectiveness by showing a reasonable fit
between means and ends; (3) that economic costs are reasonable; (4) that human
rights burdens are reasonable; and (5) that benefits, costs, and burdens are
fairly distributed. The 3 articles in this series have sought to provide a
fuller understanding of the varied ways in which law can advance the public's
health. Public health law should be seen broadly as the government's power and
responsibility to ensure the conditions for the population's health. As such,
public health law has transcending importance in how we think about
government, politics, and policy. JAMA. 2000.

The Constitution allocates public health powers among the federal
government and the states. Federal public health powers include the authority
to tax, spend, and regulate interstate commerce. These powers enable the
federal ...